Dr. Nickel and his collaborative research network have undertaken numerous etiology, epidemiology, diagnostic, and treatment studies in the field of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and interstitial cystitis/bladder pain syndrome (IC/BPS) referred to collectively as Urologic Chronic Pelvic Pain Syndrome (UCPPS). He and his research group have participated in the NIH funded CPCRN (1 and 2), ICTTG and ICCRN collaborative research networks evaluating CP/CPPS and IC/BPS respectively and Dr. Nickel was the Project Leader for the first Trans-MAPP Infection Etiology Study. Based on this experience, we hypothesize that symptom severity, impact and patterns (including flares) in defined patient phenotypes are associated with very heterogeneous patient-specific urinary microbial or microbiome patterns (or changes) as well as (partner) factors, other psychological parameters (depression, catastrophizing, illness perception), sleep, sexual status, and environment factors (diet, perceived stress, exercise). Our aim (Aim 1) is the enhance the proposed trans-MAPP Symptom Pattern Study by becoming an active Discovery Site, employing our expertise and experience to assist in patient enrollment (particularly difficult to enroll patient subtypes) as well as to suggest clinical, physical, urological and psychosocial assessment and outcome tools for predictive phenotype identification. We further plan (Aim 2) to expand our initial and ongoing trans-MAPP Infection Etiology Project (using state of the art culture independent technology) to determine the clinical implications and impact of the microbiome of the lower urinary tract on symptoms (symptom phenotype) and changing symptom patterns (including flares) in patients with UCPPS enrolled in the trans-MAPP Symptom Pattern Study.